Organization
STARDUST APPLICATIONS, LLC
Active
Other names
Stardust ABA
Organization subpart
No
Provider details
NPI number
Authorized official
MAIZEL QUIVA (CO-OWNER)
(757) 752-6900
Entity
Organization
Contact information
Practice address
1860 KEMPSVILLE CROSSING LN, VIRGINIA BEACH, VA 23464-6935
(757) 752-6900
Mailing address
1860 KEMPSVILLE CROSSING LN, VIRGINIA BEACH, VA 23464-6935
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
05/15/2020
Last updated
05/15/2020
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